| NPI | 1578096012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX U3149) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX u3149) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX U3149) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2025-06-27 |